Retinopathy in newly-diagnosed systemic lupus erythematosus: should we screen for ocular involvement?

Bashiri, Hamidreza; Karimi, Nooshin; Mostafaei, Shayan; Baghdadi, Azarakhsh; Nejadhosseinian, Mohammad; Faezi, Seyedeh Tahereh

doi:10.1186/s41927-021-00203-5

Cited by 14 publications

(9 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, Bashiri, H. et al . [ 16 ] found a relatively high rate of retinopathy in patients with SLE at the time of their initial diagnosis, even suggesting the need for ocular screening at the time of diagnosis in patients with severe disease. Prospective studies are needed for evaluating the associations between retinopathy and disease activity and prognostic indicators for ocular involvement.…”

Section: Discussionmentioning

confidence: 99%

Posterior segment involvement in systemic lupus erythematosus – A series from South India

Babu

Nanda

Hegde

et al. 2023

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

Purpose: To report the spectrum of posterior segment manifestations and visual outcomes in a large series of patients with systemic lupus erythematosus (SLE). Methods: Retrospective study at a tertiary referral eye center in south India between 2016 and 2022. Results: Charts of 109 patients diagnosed to have SLE were retrieved from our medical database. Only nine cases of SLE (8.25%) had posterior segment involvement. The male: female ratio was 1:8. The mean age was 28 years. Unilaterality was the most common presentation in eight cases (88.89%). Lupus nephritis was the most common systemic presentation in five cases (55.56%). Antiphospholipid antibodies (APLA) positivity was seen in two cases (22.22%). Ocular manifestations included microangiopathy (cotton wool spots) in one case, occlusive retinal vasculitis with cotton wool spots in four cases (five eyes), optic disc edema with combined venous and arterial occlusion (one case), central retinal vein occlusion with cotton wool spots and hemorrhages (one case), macular edema (four cases), posterior scleritis with optic disc edema and exudative retinal detachment in the posterior pole (one case), and tubercular choroidal granuloma (one case). Treatment included systemic steroids, hydroxychloroquine sulfate (HCQS), and immunosuppression in all cases, blood thinners in two cases, and laser photocoagulation in four cases. HCQS-related retinal toxicity was not seen in any of the 109 cases. Ocular manifestation was the initial presentation of SLE in one case. Visual outcome was poor in three cases. Conclusion: Presence of posterior segment findings in cases with SLE may suggest a severe systemic disease. Early detection and aggressive treatment result in better visual outcomes. Ophthalmologists could play a vital role in guiding systemic therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Posterior segment involvement in systemic lupus erythematosus – A series from South India

Babu

Nanda

Hegde

et al. 2023

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…Early retinopathy detection is crucial to prevent vision-threatening complications. The timetable for HCQ toxicity screening, for patients with no risk factors, includes baseline fundus examination to detect coexistent retinal disease and annual screening after 5 years from SLE diagnosis [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Hydroxychloroquine therapy is considered safe with good disease control but associated with dose-dependent toxicity [6]. Hydroxychloroquine retinopathy tends to increase with long-term therapy (5 or more years), high daily dose (more than 5 mg/kg per day), chronic renal disease, use of tamoxifen and preexisting retinal or macular disease [6][7][8].…”

Section: Cst -Central Subfield Thickness Gcl -Ganglion Cell Layer Oct...mentioning

confidence: 99%

See 1 more Smart Citation

Subclinical retinopathy in systemic lupus erythematosus patients – Optical Coherence Tomography study

Mimier-Janczak¹,

Kaczmarek²,

Proc³

et al. 2023

Reumatologia

View full text Add to dashboard Cite

Introduction:The aim was to detect subclinical structural retinal abnormalities in optical coherence tomography (OCT) in ophthalmologically asymptomatic systemic lupus erythematosus (SLE) patients without signs of lupus retinopathy or drug toxicity in fundus examination and in OCT and to assess the relationship between OCT parameters and disease activity, therapy type and burden on other organs to demonstrate the utility of OCT in early retinal impairment in SLE patients.Material and methods:Cross-sectional study. Thirty-three SLE patients (57 eyes) and 31 healthy individuals (56 eyes) were enrolled in the study. We excluded patients with evidence of lupus retinopathy or hydroxychloroquine (HCQ) toxicity on OCT or fundus examination to reveal any subclinical changes. All patients underwent full ophthalmologic examination in the slit lamp including best corrected visual acuity, tonometry, and OCT. The Kolmogorov-Smirnov distribution test was used to assess the normal distribution in quantitative values. The differences between the individual measured parameters in the groups were analyzed using the Mann-Whitney U test. Spearman’s rank correlation test was used to assess the correlation between the measured parameters and quantitative clinical data.Results:There was no difference in the OCT findings between SLE and healthy control groups. Among the study group a negative correlation was found between disease duration and age and retinal nerve fiber layer thickness in the inferior quadrant (p = 0.0063, p = 0.0036). No correlations were observed between examined retinal parameters and duration of hydroxychloroquine therapy, hydroxychloroquine as well as chloroquine cumulative dose and disease activity indices.Conclusions:Optical coherence tomography is a widespread ophthalmic modality used for SLE retinopathy and HCQ toxicity screening. Our study did not demonstrate its clinical potency in diagnosis of subclinical retinal involvement. An optical coherence tomography device seems to be less sensitive in subclinical retinal impairment detection than optical coherence tomography angiography.

show abstract

“…The most common manifestation of SLE is arthritis which is seen in almost half the patients with SLE, followed by malar rash [2]. Of note, SLE is a multisystem Reumatologia 2023; 61/5 disorder that affects multiple organs and can have varying presentations such as pericarditis, central nervous system disturbances, nephropathy, retinopathy and gastrointestinal symptoms [2][3][4][5]. Moreover, psychiatric manifestations including depression and anxiety are commonly seen in SLE patients [6].…”

Section: Introductionmentioning

confidence: 99%

Depression, anxiety, and quality of life in patients with systemic lupus erythematosus

Dehghan,

Soltani,

Faezi

et al. 2023

Reumatologia

View full text Add to dashboard Cite

IntroductionSystemic lupus erythematosus (SLE) is a multisystem disorder that can affect multiple organs; psy-chiatric manifestations including depression and anxiety are commonly seen in SLE. The aim of this study is to explore the prevalence of depression, anxiety, and stress, and assess the quality of life (QOL) in patients with SLE and also evaluate associated risk factors.Material and methodsIn this cross-sectional study, adult patients with SLE were identified through our institution’s SLE data registry. Participants were evaluated with three questionnaires: Depression, Anxiety, and Stress Scale (DASS-42), General Health Ouestionnaire-28 (GHQ-28), and World Health Organization quality of life instrument short form (WHO-QOL BREF).ResultsA total of 222 patients were included in the study, 203 (91%) of whom were female and 19 were male (9%). Participants had a mean age of 35.6 ±9.5 years. According to DASS-42 question-naire, 22.1%, 28.7% and 20.3% of patients had varying degrees of depression, anxiety, and stress, respectively. Based on GHQ-28 questionnaire, 137 (62%) of patients reported some degree of distress. Quality of life score was 12.8, 13, 14.3, and 13.9 in physical health, psychological health, social relationships, and environmental health, respectively.ConclusionsWe found that depression, anxiety, and stress are common in patients with SLE, and quality of life is significantly affected. A high percentage of patients with SLE deal with some degree of distress. Rou-tine evaluation of the quality of life and psychological disturbances is recommended in patients with SLE. Non-pharmacological interventions as well as specialist referral should be considered in patients with anxiety, depression, or stress.

show abstract

Retinopathy in newly-diagnosed systemic lupus erythematosus: should we screen for ocular involvement?

Cited by 14 publications

References 18 publications

Posterior segment involvement in systemic lupus erythematosus – A series from South India

Posterior segment involvement in systemic lupus erythematosus – A series from South India

Subclinical retinopathy in systemic lupus erythematosus patients – Optical Coherence Tomography study

Depression, anxiety, and quality of life in patients with systemic lupus erythematosus

Contact Info

Product

Resources

About